This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Chronic kidney disease (CKD) has become an important public health challenge in the US. CKD is a major risk factor for end-stage renal disease (ESRD), cardiovascular disease (CVD), and premature death. Understanding novel risk factors for CKD may provide effective approaches for early interventions in order to reduce the morbidity and mortality related to CKD. Endothelial dysfunction, adipocytokines and inflammation have been associated with ESRD and CVD in small clinical studies and animal experiments. However, their role in the etiology of CKD has not been established. The overall objectives of this proposed study are to examine the effects of endothelial dysfunction, adipocytokines, and inflammation on the risk of CKD. We are conducting a case-control study to compare endothelial function, adipocytokines and inflammation between cases with CKD and controls without CKD. We also plan to follow up 200-250 patients who have CKD and already enrolled in the study to examine the longituninal relationship of endothelial dysfunction, oxidative stress, adipocytokines, and inflammation to the risk of CKD.